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General NPI Number Information
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NPI Number | 1497406318
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Entity Type | Organization
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Legal Business Name | BE AT HOME PRIMARY CARE PLLC
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Dates
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Enumeration Date | 01/12/2022
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 3202 10TH LN W
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City | PALMETTO
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State | FL
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Zip | 34221-2502
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Country | US
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Telephone | 941-565-4924
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Fax | 941-357-4814
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Provider Business Mailing Address
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Address Line | 3202 10TH LN W
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City | PALMETTO
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State | FL
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Zip | 34221-2502
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Country | US
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Telephone | 941-565-4924
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Fax | 941-357-4814
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CAMMIE BAIRD
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Credential |
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Telephone | 941-565-4924
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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